Snoring and mouth breathing - enlarged adenoids?

[scarletttt]

My 14mo mouth breaths and snores a lot at night. Every time he wakes there's a wet patch where he's been dribbling.

His sleep is pretty crap - 4-6 wake-ups a night, and up for the day at 5am (despite evidently still being exhausted). I nurse him back to sleep.

I can't help but feel the two might be linked. I've tried to speak to the GP about it but got fobbed off despite being fairly insistent. He had a cursory glance at his nose and throat and declared everything to be fine. But if it was fine, why can't he breathe through his nose at night? He doesn't have a cold.

I've done some googling and it looks like a lot of his symptoms are suggestive of enlarged adenoids, which could also explain why he settles instantly after he's had a bit of milk - perhaps he's just really thirsty from having a dry mouth. Does anyone have any experience of these and how they might be treated? Or any other ideas of what could be causing this? The sleep deprivation is really killing me. We're about to start a gentle form of sleep training, but if there's something physical underlying all the night wakings I really wouldn't forgive myself for putting him through that...

My son has the same, the hospital and gps are doing the wait and see approach if they get smaller on their own, every few months he gets them checked. I think this mostly because of covid restrictions though and he might of had them removed by now.

Otherwise they partly remove them and the tonsils, which is a relatively easy and quick surgery and might not even require an overnight stay apparently.

@Peanutbutterandbananatoastie

My son has the same, the hospital and gps are doing the wait and see approach if they get smaller on their own, every few months he gets them checked. I think this mostly because of covid restrictions though and he might of had them removed by now.

Otherwise they partly remove them and the tonsils, which is a relatively easy and quick surgery and might not even require an overnight stay apparently.

@Peanutbutterandbananatoastie Thank you, that's really helpful. What sort of checks do they do to assess the size? Would be good to know so that I can go back to the GP and be more specific about what I'd like. I'm assuming I need a referral to an ENT paediatrician, and a proper assessment? Do they do a scan or an x-ray or something to check the size of the adenoids?

And in the meantime have you found anything to help relieve your son's symptoms?

My daughter mouth breathes, though doesn’t really snore. We saw a consultant ENT at the age of 5, as I also wondered about adenoids. They said that as the adenoids usually shrink by the age of 8 and they wouldn’t know for certain until they operated whether they were actually enlarged (although slightly enlarged tonsils indicated that they may have been) they wouldn’t recommend surgery. They prescribed a nasal spray to see if that would help at all. It didn’t.
DD is now nine and still mouth breathes most of the time, but I now think it is just due to habit as she will at times breathe through her nose, so I know it isn’t an issue of being unable to.

I was just going to say - even if he does have enlarged adenoids, there’s not a thing they’d do about it, I’m afraid. They do shrink over time in the vast majority of cases and I can’t see them trying the nasal spray on a 14mo.

The frequent night wakings are for boob - nothing to do with dry mouth or adenoids, sorry. Both of mine were exactly the same at 14mo. Night wean, and the night wakings will reduce dramatically/stop. I was co-sleeping anyway when I night weaned, which was probably about the same age yours is now. Two or three nights of getting screamed and clawed at for umpteen minutes every couple of hours and then it was sorted, but at least you’re there for a cuddle and reassurance. You can offer a sippy cup of water in lieu of boob if you like but it will only assuage your own guilt - it will more than likely get slapped out of your hand or thrown at your head.

Alternatively you can get your DP/DH to take him for the two or three nights of night weaning so you don’t just give in at 2am because you’re shattered and fed up of the screaming, and DS is trying to get down your top.

Also - if his breathing was so impaired by large adenoids, he’d struggle to breastfeed, wouldn’t he? But he doesn’t presumably so he’s soothing back to sleep by breastfeeding - it’s not the milk for a dry mouth. It’s perfectly fine and normal for his age to continue to need/want to nurse back to sleep, but if you can’t cope any more, he’s past 12 months so night weaning is perfectly OK from a milk intake point of view.

And neither of my DC stopped night waking until I stopped breastfeeding entirely - at 14 and 15 months.

Thanks everyone.

I’m not totally convinced it’s actually about the boob. I say this because up until a few months ago he wasn’t snoring and would only wake once or twice overnight. Then he got a series of really bad colds and viral infections, and even though he recovered, he the snoring persisted, and he started waking much more often at that point.

So I think the boob could well be encouraging some wakes, but definitely not all of them.

@ElphabaTheGreen why do you say you don’t see them trying a nasal spray on a 14mo old? It feels like a pretty non invasive thing to try?

You didn’t mention the history of infections! Have you tried Piriton to see if it reduces the snoring at all? He may have developed a hypersensitivity to something as a result (eg dust) which might respond to an antihistamine.

The reason I’m not sure if they’d use a nasal spray in a 14mo old is because if it’s with a view to shrinking adenoids, they’d probably be steroid-based and I would have thought they’d want him to try and grow out of it before risking steroids on a ‘maybe’ in a baby. I doubt they’d bother trying to scope him to confirm either - too invasive for him and not worth the risk of sedation when it might not change the advice from ‘wait and see’.

I’m still dubious, though. If he was so congested it was affecting his sleep, I think he’d struggle to feed. I’m still inclined to think it’s waking to soothe. Sleep is a rollercoaster, not an upward curve for the first two to three years. Just because he was waking less a few months ago doesn’t mean he should be the same or better now.